![]() ![]() Articles were located using a PubMed search, using a variety of keywords related to cracked tooth diagnosis and treatment, and by hand-searching selected citations contained within located articles. This article reviews the literature on cracked tooth diagnosis and treatment, provides an alternative concept for the description, diagnosis, and treatment of the cracked tooth phenomenon, and assesses the scientific validity of various terms that have been used to describe cracked teeth. ![]() A partial fracture is potentially noncatastrophic if complete fracture of the stress plane would result in a tooth that would still be restorable with a direct restoration, a crown, or an endodontic procedure, post/core and crown. Various types of cracks–furcation fractures, cuspal fractures, root fractures, gingival interface fractures, or craze lines may be defined, depending on what structures the stress or fracture planes intersect.Ī partial fracture of a stress plane is potentially catastrophic if complete fracture of the stress plane would result in the tooth being nonrestorable with a crown or an endodontic procedure, post/core and crown. A tooth stress plane or fracture plane may be completely supra-gingival and may or may not intersect the pulp chamber, or may intersect the pulp chamber (potentially causing pulpal necrosis), a furcation (potentially causing tooth root disconnection), a sub-gingival aspect of the root surface (potentially causing chronic periodontal inflammation), or a tooth root (potentially destroying the root or making it impossible to endodontically seal the root). The biomechanical and periodontal prognoses and the treatment requirements of a cracked tooth depend on what aspects of the tooth are intersected by the existing partial fracture of the stress plane, or would be intersected if the stress plane completely fractured. Sometimes, however, a single traumatic hit can simultaneously initiate a tooth stress plane and also completely fracture that stress plane. Eventually, the stress plane fractures completely, resulting in a tooth piece separating completely along this stress plane. With enough fracture area expansion, occlusal forces may become capable of causing the tooth structure around the fractured area to flex, which may result in sensitivity, if the stress plane is contiguous with the periodontal ligament or the pulp chamber, or perhaps if such flexure causes fluid movement within odontogenic processes. As the fracture plane expands, the rate of fracture of the stress plane theoretically accelerates, due to proportionately increased stress being put on the remaining nonfractured area of the stress plane. With many masticatory cycles, a clinically significant fracture plane may develop on the stress plane. This instance of higher energy may result in fracture of some of the chemical bonds of the natural tooth structure that traverses the stress plane. A tooth stress plane results from occlusal forces that are commonly imposed on that tooth that may cause, during a masticatory cycle, an instance of higher energy to occur within the stress plane. Articles on cracked tooth phenomena were located via a PubMed search using a variety of keywords, and via selective hand-searching of citations contained within located articles.Ī cracked tooth is a tooth in which there exists a partial or complete fracture of a stress plane that commonly occurs in that tooth. The article explores what biomechanical factors help to facilitate the development of cracks in teeth, and under what circumstances a full coverage crown may be indicated for preventing further propagation of a fracture plane. The article explains the advantages of high magnification loupes (×6–8 or greater), or the surgical operating microscope, combined with co-axial or head-mounted illumination, when observing teeth for microscopic crack lines or enamel craze lines. ![]() ![]() This article provides alternative definitions of terms such as cracked teeth, complete and incomplete fractures and crack lines, and explores the scientific rationale for dental terminology commonly used to describe cracked teeth, such as cracked tooth syndrome, structural versus nonstructural cracks, and vertical, horizontal, and oblique fractures. This article reviews the diagnosis and treatment of cracked teeth, and explores common clinical examples of cracked teeth, such as cusp fractures, fractures into tooth furcations, and root fractures. ![]()
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